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The Benefits of Oral Rehydration on Orthostatic Intolerance in Children with Postural Tachycardia Syndrome.
Medow, Marvin S; Guber, Kenneth; Chokshi, Shilpan; Terilli, Courtney; Visintainer, Paul; Stewart, Julian M.
Afiliação
  • Medow MS; Department of Pediatrics, New York Medical College, Valhalla, NY; Department of Physiology, New York Medical College, Valhalla, NY. Electronic address: marvin_medow@nymc.edu.
  • Guber K; New York Medical College, Valhalla, NY.
  • Chokshi S; New York Medical College, Valhalla, NY.
  • Terilli C; Department of Pediatrics, New York Medical College, Valhalla, NY.
  • Visintainer P; Department of Epidemiology and Biostatistics, Baystate Medical Center, University of Massachusetts School of Medicine, Worcester, MA.
  • Stewart JM; Department of Pediatrics, New York Medical College, Valhalla, NY; Department of Physiology, New York Medical College, Valhalla, NY.
J Pediatr ; 214: 96-102, 2019 11.
Article em En | MEDLINE | ID: mdl-31405524
OBJECTIVE: To evaluate whether equal volumes of oral rehydration solution (ORS) or intravenous (IV) saline provide similar improvements in cardiovascular status during controlled orthostatic challenge when administered to subjects with postural tachycardia syndrome (POTS) with orthostatic intolerance. STUDY DESIGN: We studied the neurovascular response to fluid loading during orthostatic stress using lower body negative pressure (LBNP) in 10 subjects with POTS with orthostatic intolerance and 15 controls, and on subsequent days before and 1 hour after IV saline infusion or ingestion of ORS. RESULTS: Subjects with POTS exhibited reduced tolerance to LBNP (P < .0001) compared with controls (Orthostatic Index of 35 715 ± 3469 vs 93 980 ± 7977, respectively). In POTS, following ORS but not saline infusion, cerebral blood flow velocity (CBFv) was significantly higher than that with no treatment, at -45 mm Hg (P < .0005). Although fluid loading did not confer any advantage in controls, subjects with POTS experienced a significant improvement in orthostatic tolerance following both saline infusion (100 ± 9.7 vs 134.5 ± 17.4; P < .05) and ORS (100 ± 9.7 vs 155.6 ± 15.7; P < .001) when evaluated by normalized orthostatic index (P < .001, compared with untreated baseline). CONCLUSIONS: Maintenance of CBFv may have resulted in the improved short-term orthostatic tolerance exhibited by the subjects with POTS following ORS administration. ORS is a convenient, safe, and effective therapy for short-term relief of orthostatic intolerance.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome da Taquicardia Postural Ortostática / Hidratação Tipo de estudo: Observational_studies Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: J Pediatr Ano de publicação: 2019 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome da Taquicardia Postural Ortostática / Hidratação Tipo de estudo: Observational_studies Limite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: J Pediatr Ano de publicação: 2019 Tipo de documento: Article País de publicação: Estados Unidos